The microbes that inhabit the vaginal vault, play a major role in illnesses of the host, such as sexually transmitted diseases including HIV, cancer, urinary tract infection, bacterial vaginosis and yeast vaginitis, as well as in the maintenance of a healthy tract. An understanding of the nature and functionality of these organisms has progressed in recent years, but it is still far from optimal. For some time the flora of so-called ‘normal’ women of child-bearing age, was believed to be dominated by Lactobacillus acidophilus and L. fermentum followed by L. brevis, L. jensenii, L. casei, and other species. Altschul et al. (1990) J Mol Biol 215:403-10. More recently, molecular methods have shown L. crispatus and L. jensenii to be the most common isolates. Altschul et al. (1990) J Mol Biol 215:403-10; Antonio et al. (1999) J Infect Dis 180:1950-6; ben Omar et al. (2000) Appl Environ Microbiol 66:3664-73. In only one study has a previously undescribed species been found in 15% of women. Antonio et al. (1999) J Infect Dis 180:1950-6. The development of denaturing gradient gel electrophoresis (DGGE) has provided a tool to analyze a given population of organisms in the host. Traditionally, studies of the urogenital microflora have been conducted by collecting urine samples or vaginal swabs and analysing the contents by bacteriological culture techniques or by Gram-stain analysis (Nugent et al. (1991) J Clin Microbiol 29:297-301). Identification and tracking of cultivated isolates from the vaginal tract by molecular biological techniques has aided ecological studies, although these are logistically demanding for use in large clinical trials (Antonio et al. (1999) J Infect Dis 180:1950-6; Reid et al. (1996) FEMS Immunol Med Microbiol 15:23-6; Zhong et al. (1998) Appl Environ Microbiol 64:2418-23). Also, certain microbes are difficult to cultivate from the vaginal tract due to their anaerobic nature, while others may yet remain to be cultivated (Larsen et al. (2001) Clin Infect Dis 32:69-77. However, the effectiveness of DGGE compared to conventional Gram-stain analysis (Nugent scores) and culture has not been assessed in relation to the determination of which Lactobacillus species actually inhabit the vaginal flora of pre- and post-menopausal women. Once an identification of species has been determined, administration of appropriate Lactobacillus strains for the restoration of urogenital health, for example, is readily accomplished.
Continuous application of certain Lactobacillus strains orally and vaginally has shown to alter the flora from one indicative of bacterial vaginosis to one that is dominated by lactobacilli and regarded as normal. Larsen et al. (2001) Clin Infect Dis 32:69-77; Muyzer (1999) Curr Opin Microbiol 2:317-22; Muyzer et al. (1998) Antonie Van Leeuwenhoek 73:127-41; Instillation of probiotic lactobacilli can make a significant impact on the health of women.